Just after dawn Sunday morning at Stadium School in northeast Baltimore, volunteers pulled cars into the parking lot next to a sign that said the clinic’s capacity had been reached. The patients, some of whom slept in their vehicles all night to make sure they were seen, were already inside talking to triage personnel about the medical or dental issues that had brought them there, which they hadn’t been able to address. deal with anywhere else.
A semi-trailer emblazoned with the words Remote Area Medical sat at the far end of the parking lot. The Knoxville, Tennessee-based non-profit shop set up shop in Baltimore for the weekend to host a pop-up clinic event where volunteer providers provided a range of medical and dental services for free.
Inside, East Baltimore’s Kisha Hargrove sat in rows with other patients in a hallway outside a classroom where several makeshift exam rooms had been set up. Hargrove came seeking dental treatment for a toothache she had been having for a few weeks, but she arrived two minutes after the clinic opened at 6am too late to snag one of the coveted seats. She hoped to get antibiotics prescribed by one of the doctors to beat the infection, but she didn’t know what she would do to fix the tooth itself.
Hargrove, 48, gets Social Security disability benefits and therefore has Medicare, which offers no dental or vision coverage. She said, “It’s been so long since he’s seen a dentist, he can’t remember the last time.”
While Maryland’s efforts to plug the holes in a fragmented health insurance system have been much more robust than in other states, large gaps remain, leaving behind people who need care enough to sleep in a dark parking lot only to increase their chances of getting treatment.
Adults with Medicaid, for example, earlier this year I just received dental benefits, but 35,000 people lost coverage this month due to post-pandemic mass renewal and thousands more will be canceled over the next year. Even people with commercial insurance, whether through their employers or through a state health benefit exchange, often face large deductibles and copays that cause them to avoid health care unless it is of an emergency.
Gary Johnson, 60, of Catonsville, has insurance through his employer but struggles to afford the 40 percent copays for dental care. He came to the pop-up clinic to see a dentist but, like Hargrove, he just missed the mark, so he stayed put for a physical exam.
Free events like those offered by Remote Area Medical give people the chance to understand what theirs is [health] the state is, Johnson said. People are so concerned about health care, in terms of cost and time taken away from work to go to the doctor, he said, that many people here wouldn’t go to the doctor if it weren’t free.
Many of our patients work full-time, they just can’t afford the deductible, said Mary Johnson, volunteer manager for Remote Area Medical, who is not related to Gary Johnson. Or they have no teeth or vision.
Some of the patients, however, are completely uninsured. Many are immigrants, some undocumented, who are almost excluded from the insurance system. Remote Area Medical typically has volunteer interpreters who speak many different languages on Sundays they offered Spanish, Mandarin, Vietnamese and Turkish.
One such patient is 39-year-old Carla Amador-Games, who emigrated from Honduras a year and a half ago and lives in eastern Baltimore County with her five children and another renter. Amador-Games works in interior demolition for an asbestos abatement company and has not sought medical treatment since she has been in the country.
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About three months ago, Amador-Games started experiencing persistent pain in her kidneys and started taking over-the-counter pain relievers to manage it. After about three weeks, the pain suddenly became so intense that she could not bear it. I was screaming, he said in Spanish, and went to the ER.
She was hospitalized for three days with anemia and a severe kidney infection, she said. She was discharged with instructions to follow up with a primary care physician as soon as possible and given the phone number of Healthcare for the Homeless, a health center in the city of Baltimore, but could not get an appointment because she has housing stable, he said.
Amador-Games is worried, she said, because she hasn’t seen a doctor since her hospitalization, so she came to the free clinic to make sure she was okay. Sometimes her kidneys still hurt, she said, especially when she’s up to work.
Many patients who come to Remote Area Medical events need follow-up care, said Medical Supervisor Colleen Madigan, especially those with chronic conditions, such as diabetes or high blood pressure. We can’t fix it in one visit, she said. DentMed, the local organization partnering with Remote Area Medical to host the event, is tasked with connecting patients to free or low-cost care in the community. Chief Executive Portia Ackridge said she sometimes follows patients up for months to make sure they can get an appointment.
Remote Area Medical typically offers free eye exams and glasses even at pop-up clinics, but there weren’t enough volunteers to do it in the Baltimore area. Chris Cannon, media relations coordinator for the nonprofit, said he had to turn away an ophthalmologist who volunteered at the last minute because he didn’t have time to complete Maryland’s lengthy approval process. of medical volunteers from out of state.
He said 11 states, including Tennessee, where the nonprofit is based, have open systems where the organization can verify state licenses and submit them to the receiving state’s medical board. This makes it much easier for them to organize pop-up events that are well staffed and able to deliver a range of care for a large volume of patients, she said.
Remote Area Medical saw 87 dental patients and provided 112 doctor visits over the weekend, Cannon said. Only 10 of those dental visits took place on Sunday, as the clinic had only one volunteer dentist, Dr. Michael Seitz, who hails from Cornwall, New York, and volunteers in several states about once a month along with his wife, Young Kim, a pediatric nurse anesthetist who acts as his assistant and helps out wherever needed in the clinic.
On Saturday, several fourth-year dental students at the Howard University College of Dentistry provided supervised care, Cannon said.
Seitz said it’s fun and rewarding to volunteer; You have to give [patients] their smile back. She noticed that the last patient she saw of hers was covering her mouth in embarrassment about badly decayed and missing teeth. Seitz said he often treats patients who haven’t seen a dentist in years or sometimes never, and have multiple dental problems.
The first goal is always to relieve pain, she said, as many patients suffer from infected or abscessed teeth. He tries to take care of the patient’s second biggest problem as well, she said, but the third biggest might not be met.
Unlike other free dental clinics that only do fillings and extractions, Seitz and a few other dental volunteers at RAM provide detailed restorative care, preserving teeth and fixing decay whenever they can.
Kim said patients sometimes get excited when they see how much their teeth have been transformed.
Teeth reflect a person’s status, Kim said, noting that teeth are indicators of general health, diet and social class. Bad teeth make it harder for people to secure employment and can affect their self-esteem.
Cannon said dental care is the most requested service at RAM clinics, accounting for 60% of the care provided.
Sandtown-Winchester resident Jeanette Snowden, 66, showed up early Sunday morning to get her teeth cleaned after being turned away from the clinic on Saturday. Snowden has both Medicare and Medicaid benefits, but she was unaware that her Medicaid covers her dental care. In 2019, Maryland launched a pilot program covering $800 of dental care annually for dual-covered people who previously had no benefits.
The complexity of the health insurance system can make it difficult for people to figure out what care they have access to, Kim said, and benefits for both public and private insurance are often evolving.
We are a very rich country here, Kim said. Dental care should be given to everyone.
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